Management of Cesarean Scar Pregnancy: A Case Series

Objective To survey effective treatment strategies for cesarean scar pregnancy(CSP). Methods The clinical data of 78 patients diagnosed with CSP from January 2010 to December 2013 were reviewed. Results Among these patients, 17 patients were first treated at our hospital; of them, 2 were misdiagnosed. The other 61 patients were referred from other hospitals; of them, 21 were initially misdiagnosed. There were 9 patients who were treated with laparotomy, 50 patients with curettage after uterine artery embolization(UAE) with or without local methotrexate(MTX) infusion, 10 patients with dilatation and curettage, 6 patients with transvaginal sonographic guided local intragestational MTX injection, and 3 patients with systemic MTX injection. All patients finally recovered. Patients with excessive vaginal hemorrhage underwent either emergency UAE treatment or laparotomy. These two treatments had similar success rates(81.82% vs. 100%, χ2 =0.289, P>0.05). Conclusions The accurate diagnosis of CSP is important. Curettage after UAE with or without local MTX infusion is a safe and effective method.